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Coxsackievirus

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Coxsackievirus

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USMLE® Step 1 style questions USMLE

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A 4-year-old boy is brought to the emergency department by his parent because of difficulty in feeding him for a day. The parent reports that the patient felt warm last night, but he did not have any chills, myalgia, cough or sneezing. Past medical history is unremarkable. The patient is up to date on his vaccinations. Temperature is 37.7°C (100°F), pulse is 80/min, respirations are 19/min and blood pressure is 110/78 mmHg.  Physical examination shows a maculopapular and vesicular rash scattered on the palms and soles bilaterally. Oropharyngeal examination shows superficial ulcers with a greyish-yellow base and an erythematous rim on the tongue and buccal mucosa. Which of the following is the most likely causative agent of this patient’s condition? 

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Summary

Coxsackievirus is a single-stranded RNA virus belonging to the enterovirus genus and the picornaviridae family. It primarily affects the gastrointestinal tract and is mainly transmitted via the feco-oral route. Based on its pathogenicity, Coxsackievirus is divided into two groups: A and B. Coxsackievirus group A affects the skin and mucous membranes, causing hand-foot-mouth disease in children, and coxsackievirus group B, affects internal organs, resulting in more severe conditions such as gastroenteritis, pericarditis, myocarditis, and encephalitis.